“For people like me with fibromyalgia, it’s amazing in that it can provide pain relief while fighting fatigue,” she says.
Adeel Khan, MD, MPH, MS, a hematologist, oncologist, epidemiologist, and assistant professor at the University of Texas Southwestern Medical Center, sees more of his cancer patients turning to kratom in lieu of opioids to mitigate pain and enhance well-being… but not exactly with his approval.
“As it’s an unregulated substance and without strong clinical research behind it, it’s not something I recommend, nor do most practitioners—but admittedly it simply has not been properly studied in this space,” he says.
Kratom’s effects hinge upon a host of factors, including the form (leaf, extract, concentrate), whether you consume an isolate, and serving size. In general, Ross says that a small dose (1 to 3 grams) of kratom can function like coffee, energy drinks, or even mild ADHD medications by boosting focus, attention, and energy. A medium dose (3 to 7 grams) may increase focus and offer mild pain relief, while a high dose (7 to 15 grams) can induce sleep and reduce pain more significantly.
“Anything over 15 grams of powder or leaf can lead to side effects such as nausea, vomiting, dizziness, seizure, and coma,” Ross warns. High doses and tainted products can also be lethal.
It’s worth noting that doses aren’t usually standardized, and tolerance also varies.
“Because of genetic variations in the CYP3A4 enzyme that breaks down mitragynine into 7-OH in the liver and gut, there is also variation in individual [metabolic] response to kratom,” Ross adds. In other words, a small dose for one person could be a large dose for another.
What Are the Risks of Kratom and 7-OH?
While kratom may offer therapeutic benefits for some people, its risks appear to outweigh potential rewards in terms of sheer quantity and severity.
“The biggest misconceptions are that kratom is safe, it generally supports health, and is not habit-forming,” says Eileen Barrett, MD, MPH, a board-certified internist and addiction physician. However, the reality is much more complex.
Since kratom isn’t currently regulated by the Food and Drug Administration (FDA), the onus is on the consumer to vet for product safety and quality.
“They need to look at third-party lab testing and make sure the product has been tested for heavy metals, residual solvents, bacteria, mold, and adulterants, and has the correct [dosage] of active ingredient stated on the label,” says Ross.
In the past few years, kratom intake has been linked to heavy metal exposure and salmonella outbreaks—not to mention increased visits to ERs and drug treatment centers.
Some believe that kratom and 7-OH are lesser evils than opioids to reduce pain and treat withdrawal symptoms. “Kratom is awesome for harm reduction and the next step in freedom of opiate addiction,” one Reddit user posted a year ago.
Yet since they all have potential for abuse, Dr. Ey says you’d merely be swapping one addiction for another. Another Redditor agrees, saying that, in their experience, replacing opioids with kratom created “just another grey [area] to stumble into for years prolonging the inevitable.” The widespread availability and burgeoning popularity of 7-OH in particular are leading to a potential epidemic.
